It may have started as back pain. But it was not ordinary back pain.
It was severe, deep, and it did not let up. Maybe it was worse at night, or when you lay down. Maybe you had a fever or chills. Maybe the pain shot down into your arms or legs. And then came the truly frightening signs. Numbness or tingling. Weakness in your legs. Trouble walking. Maybe you started to lose control of your bladder or bowels. Something was pressing on your spine, and it was getting worse by the hour.
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Article written by Brendan Lupetin, Esq. Brendan is a managing partner in the law firm of Lupetin & Unatin, a medical malpractice law firm located in Pittsburgh and serving Western Pennsylvania.
Our practice is limited to high-value catastrophic cases because that is where we can do the most for our clients and for patient safety.
So you got help. You went to the ER or to your doctor. You told them about the terrible back pain. And maybe they treated it like a routine problem. A pulled muscle. A disc. Sciatica. Maybe they gave you pain medicine, told you to rest, and sent you home. Maybe they did an X-ray that looked fine. The whole time, an infection was swelling in the space around your spinal cord, squeezing the nerves.
By the time someone ordered the right scan, the damage may have been done. A spinal epidural abscess can cause permanent paralysis if it is not treated fast. Maybe you survived but cannot walk, or lost control of your body, or live in constant pain. Maybe you are reading this because someone you love did not survive. And you cannot stop asking: why didn’t they catch this in time?
That question matters. A spinal epidural abscess is a true emergency, and the window to prevent paralysis is short. When it is missed or treated too slowly, the harm is often catastrophic and often preventable. This article explains the warning signs that a spinal epidural abscess was missed. It explains the serious harm a delay can cause. And it explains what you can do next. If any of this sounds like your story, Lupetin & Unatin is here to help.
What a Spinal Epidural Abscess Is, in Plain Terms
Your spinal cord runs down your back inside the spine. Around it is a thin space called the epidural space. A spinal epidural abscess is a pocket of infection and pus that forms in that space. As it grows, it presses on the spinal cord and the nerves.
As the Cleveland Clinic explains, an epidural abscess is a medical emergency that can be fatal if it is not treated quickly, and it can cause permanent damage to the body. Treatment usually means strong antibiotics and, in many cases, surgery to drain the abscess and take the pressure off the spinal cord. These treatments work best when they are done early.
The key word is time. The abscess can grow and the nerve damage can advance over hours to days. Once the spinal cord is badly injured, the loss may be permanent. That is why a fast diagnosis matters so much. The gold-standard test is an MRI with contrast, which can show the abscess clearly.
Why a Spinal Epidural Abscess Gets Missed
Here is the central trap. Back pain is one of the most common reasons people see a doctor, and almost all of it is harmless. So when a patient comes in with back pain, many providers assume a muscle strain, a disc problem, or sciatica. A spinal epidural abscess hides inside that very common complaint.
Doctors are taught about a “classic triad” of back pain, fever, and nerve problems. But here is the catch that makes this condition so dangerous. Studies show that all three signs appear together in only about 1 in 10 cases. Most patients do not show the full picture early on. As the Merck Manual explains, the key test is an MRI, and rapid treatment is needed to prevent or minimize lasting problems. Doctors are warned not to wait for clear nerve damage to appear before ordering imaging, because by then it may be too late.
Here are the common reasons a spinal epidural abscess gets missed:
- Severe back pain was treated as a routine strain, disc, or sciatica.
- A fever along with back pain was not connected to a possible infection.
- Risk factors like diabetes or IV drug use were not taken into account.
- No MRI was ordered, or only an X-ray or plain CT was done.
- Doctors waited for clear weakness or paralysis before imaging.
- Early numbness, weakness, or bladder changes were missed or dismissed.
Risk Factors Doctors Are Supposed to Consider
Some people are at much higher risk of a spinal epidural abscess. These risk factors matter twice. They make the condition more likely. And they are supposed to raise a careful doctor’s suspicion when a patient comes in with severe back pain and possible infection.
Common risk factors include:
- Diabetes. This is one of the most important risk factors. A diabetic patient with severe back pain and fever should raise concern.
- Intravenous (IV) drug use. Injecting drugs can introduce bacteria into the blood that settle near the spine.
- A recent infection anywhere in the body. A skin infection, blood infection, urinary infection, or dental infection can spread to the spine.
- Recent spinal procedures or injections. Spine surgery, epidural injections, or catheters can introduce infection into the epidural space.
- A weakened immune system. Cancer, HIV, long-term steroid use, and other conditions lower the body’s defenses.
- Kidney disease and dialysis. These raise the risk of serious infection.
- Alcohol use disorder. This can weaken the immune system over time.
Here is why this matters for your case. A patient with diabetes, IV drug use, a recent infection, or a recent spine procedure who comes in with severe back pain is not a routine backache. A careful doctor should think about a spinal epidural abscess, check inflammatory markers in the blood, and order an MRI. When those clues are in the chart and the doctor still treats it as a simple strain, that can be a failure to meet the standard of care.
Signs Your Spinal Epidural Abscess Was Missed
Below are the red flags. If you recognize several of these, it may be worth a closer look at the care that was given.
Severe Back Pain Was Treated as a Routine Strain
Back pain is the most common first symptom of a spinal epidural abscess. With this condition, the pain is often severe, focused on one spot on the spine, and does not ease with rest. If you had this kind of pain and it was brushed off as a pulled muscle or a disc without a deeper look, that is a red flag.
You Had Back Pain Plus a Fever
Fever with severe back pain is a warning sign of infection near the spine. The two together should make a doctor think about a serious cause, not just a strain. If you had both and no one looked for an infection, that may point to a missed diagnosis.
Your Risk Factors Were Ignored
If you have diabetes, use IV drugs, had a recent infection, or had a recent spine procedure, those facts should have shaped your care. If you came in with severe back pain and no one connected it to your risk factors, the diagnosis may have been missed.
No MRI Was Ordered
An MRI with contrast is the test that finds a spinal epidural abscess. An X-ray or a plain CT can miss it. When the signs and risk factors point to an abscess, an MRI should be ordered without delay. If hours or days passed with no MRI, that gap could be a failure to meet the standard of care.
Doctors Waited Until You Had Weakness or Paralysis
A dangerous mistake is to wait for clear nerve damage before acting. By the time a patient cannot move their legs, the harm may already be permanent. The right time to image and treat is before that happens. If your care was a series of “let’s watch it” while the warning signs grew, that delay can be devastating.
Early Nerve Signs Were Missed or Dismissed
Numbness, tingling, leg weakness, trouble walking, or new trouble controlling your bladder or bowels are serious warning signs. They mean the spinal cord may be under pressure. If you reported these and nothing was done quickly, that delay can cost you the use of your body.
You Suffered Lasting Harm
Sometimes the clearest sign that something went wrong is the outcome itself. People diagnosed before nerve damage sets in often recover well. When treatment comes too late, the damage can be severe and permanent. The next section covers the serious harm a delay can cause.
The Serious Harm a Spinal Epidural Abscess Delay Can Cause
When the abscess is not drained and treated in time, it crushes the spinal cord and nerves, and the infection can spread. The longer the delay, the more harm it does. A delayed diagnosis is one of the most common types of medical malpractice that cause spinal cord injuries. Here are the serious injuries and outcomes a missed or delayed diagnosis can cause.
Permanent paralysis. This is the most feared outcome. When the spinal cord is compressed for too long, the paralysis can be permanent. Depending on the level of the spine, this can affect the legs, or the arms and legs both.
Loss of bladder and bowel control. Pressure on the nerves can cause lasting loss of control over the bladder and bowels. This is life-changing and often permanent.
Chronic, severe nerve pain. Many survivors are left with constant burning or shooting nerve pain that is hard to treat.
Loss of sensation. Numbness and loss of feeling in the legs or lower body can be permanent.
Inability to walk. Even short of full paralysis, the nerve damage can leave a person unable to walk without help, or unable to walk at all.
Sepsis. When the infection spreads into the blood, it can cause sepsis, a life-threatening reaction that can shut down the organs.
Death. In the most severe cases, the infection or its complications can be fatal. If you lost a loved one this way, your family may have a wrongful death claim.
Repeated surgeries and long hospital stays. Treatment often means surgery, weeks of IV antibiotics, and long stays in the hospital and rehab.
Lasting disability. Many survivors cannot return to work or to the life they had before. They may need wheelchairs, catheters, and lifelong care.
Emotional trauma. Losing the use of your body, or losing a loved one, leaves deep wounds. Many people and families struggle with depression, anxiety, and grief for years.
Many of these outcomes share one thing in common. They often trace back to time that was lost. Time that doctors had to act, and did not use.
When a Missed Diagnosis Becomes Malpractice
Not every bad outcome is malpractice. Doctors do not have to be perfect, and a spinal epidural abscess is genuinely hard to diagnose because it hides behind common back pain. But doctors do have to meet a basic standard. That standard is the level of care a careful doctor would have given in the same situation.
To have a malpractice case, a few things usually need to be true. First, there was a doctor-patient relationship. Second, the care fell below the accepted standard. Third, that failure caused real harm. Fourth, the harm led to losses, such as medical bills, lost income, the loss of a loved one, or pain and suffering.
Spinal epidural abscess cases often turn on a few key questions. Did the patient have severe back pain, fever, or risk factors that should have raised suspicion? Were inflammatory markers checked? Was an MRI ordered in time? Did the team wait for paralysis before acting? When the signs were there and no one acted, that delay can be the heart of a strong case. Proving it takes work, records, and the right medical experts. That is where Lupetin & Unatin comes in.
What You Should Do Now
If you think your spinal epidural abscess, or that of a loved one, was missed, take these steps.
Get the medical records. You have a right to them. They hold the timeline of what happened and when. In these cases, the timing is often the whole case.
Write down what you remember. Note when the pain started and how it changed. Note any fever, numbness, weakness, or bladder problems, and when they began. Note what you told the doctors, what tests were done, and how long everything took. Memory fades, so do this soon.
Do not wait too long to ask questions. Every state has a deadline for filing a malpractice claim. In Pennsylvania, that deadline is usually two years. There are some exceptions, but the clock can run out fast. Acting early protects your rights.
Talk to a lawyer who knows these cases. Spinal epidural abscess claims are complex. They need medical experts and a deep understanding of emergency, neurological, and surgical care. A general lawyer may not be the right fit. A firm focused on medical malpractice will know what to look for.
How Lupetin & Unatin Can Help
We are Lupetin & Unatin. We are a Pittsburgh medical malpractice firm. We focus on serious injury and death from medical errors. Cases involving missed and delayed diagnosis, including spinal infections that lead to paralysis, are at the heart of our work. We know how these errors happen. We know how hospitals defend them. And we know how to hold them accountable.
We have handled catastrophic delayed-diagnosis and wrongful death cases. We understand how a treatable emergency can turn into permanent paralysis or death when the warning signs are missed and the clock runs out. We know the medicine, and we know how to prove what a careful doctor should have done.
We take a small number of cases so we can give each one real attention. We work on contingency. That means you pay nothing up front. You pay nothing unless we win. There is no risk in finding out if you have a case.
You deserve answers. You deserve to know if this suffering or loss could have been prevented. A short conversation can tell you a lot.
Frequently Asked Questions
You may not know for sure on your own. That is normal. The answer is usually in the medical records. We look at what symptoms were reported, what risk factors were known, whether the doctors checked for infection, whether an MRI was ordered, and how long everything took. This condition hides behind common back pain, but the law asks what a careful doctor would have done with the same information. A careful review tells us whether the care fell below the standard. That review costs you nothing.
In most cases, the deadline in Pennsylvania is two years. For a wrongful death claim, that period generally runs from the date of death. Some exceptions can change the deadline. These rules are tricky, especially in cases involving a death. The safest move is to call us soon so we can protect your rights before time runs out.
Nothing up front. We work on contingency. That means we only get paid if we win money for you. There is no fee to talk with us and no fee to review your case. If we take your case and do not win, you owe us no attorney fee. This lets you seek justice without financial risk.
Reach Out Today
If any part of this article sounds like your story, please contact Lupetin & Unatin. Tell us what happened. We will listen. We will review the records. We will tell you honestly whether we think there is a case.
A spinal epidural abscess can take away the use of your body in a matter of hours. A missed diagnosis can change everything. If a hospital or doctor failed you or someone you love, you have the right to seek justice. Let us help you find out what really happened.
Call Lupetin & Unatin today for a free, no-pressure review of your case.